Prepared by:

Rosel G. Sarmiento, RPh

PDEA-CAR
Administration of parenteral drugs to patients should be performed by at least one
registered nurse and witnessed by a competent other

The order to the nurse on duty by the attending physician shall always be in writing unless
in emergency situations.
The word “administered” shall be written following administration of the dangerous drug.

For oral dangerous drugs, the patient should be observed swallowing the medication
 ADMINISTRATION SHEET

Drug Administration information, to be filled

up by the ward NURSE

Remarks: qty of
Signed by the ward unused, verbal order,
Reference to out of stock procured
nurse before
requisition sheet from another
submission to
pharmacist pharmacy outside the
hospital
 REQUISITION SHEET
Shall bear the Hospital
Heading

Date

Provide Requisition # for

easy reference

only one drug preparation

per requisition

Signed by the ward Nurse

Conformed by the Physician

Pharmacist’s Decision

Signature of the receiving

Nurse
 Sample of a completely filled-out admin sheet

With reference to REQUISITION No:____OP 0094-K___________________

Name of Controlled Drug Preparation;__DIAZEPAM 5MG/2ML_____
Quantity:_____10 VIALS____________________
100mg
Date of Time Full Name of Patient Room/ Name of S2 License No Physician’ Name of PRC Nurse’s Dose Balance Remarks
Admin of Patient Hospital Bed No Prescribing s Administer License No Signature
Admin ID No Physician Signature ing Nurse

4/1/1 8:00 Darna 12345 0B Rod Turte 246800EM18- Sara 54321 5mg 5mg
8 am Bato 001 Inday wastage/
Nurse
witness
 Sample of a completely filled-out admin sheet

With reference to REQUISITION No:____OP 0094-K___________________

Name of Controlled Drug Preparation;__NALBUPHINE 10MG/ML_____
Quantity:_____10 AMPS____________________ April 25, 2018

______0m
g
Date of Time Full Name of Patient Room Name of S2 License No Physician’ Name of PRC Nurse’s Dose Balance Remarks
Admin of Patient Hospital / Prescribing s Administe License Signature
Admin ID No Bed Physician Signature ring Nurse No
No

4/1/1 8:00 Darna 12345 0B Rod Turte 246800EM18- Sara 54321 5mg 95mg Nurse
8 am Bato 001 Inday witness
WHAT WILL HAPPEN IF A PERSON WILL VIOLATE THE BOARD
REGULATION?

Sec 32 of Republic Act 9165 (Comprehensive Dangerous Drugs Act of 2002) Art
II:

Liability to a person violating any regulation issued by the Board (Board Reg 1
series 2014):

Penalty of imprisonment ranging from 6 months and 1 day to 4 years

and a fine ranging from Php 10,000.00- Php 50, 000 in addition to the
Administrative sanctions imposed by the Board.
 LIABILITY FOR VIOLATION OF THE REGULATION

1. 1ST Violation- fine of Php20,000.00 and warning that a repetition

of the same offense will be dealt with accordingly.

2. 2nd Violation- fine of Php35,000.00 and warning that a repetition

of the same offense will be dealt with more severely.

3. 3rd Violation- responsible officials and persons shall be criminally

liable for violation of Sec 32, Art II in addition to suspension or
revocation of license
Good Day!!